Autoimmune Diseases最新文献_第5页

Infiltrating CD16+ Are Associated with a Reduction in Peripheral CD14+CD16++ Monocytes and Severe Forms of Lupus Nephritis 浸润性CD16+与外周CD14+CD16++单核细胞减少和严重狼疮性肾炎有关

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-12-13 DOI: 10.1155/2016/9324315

Anabel Barrera García, J. A. Gómez-Puerta, L. Arias, C. Burbano, M. Restrepo, A. Vanegas, C. H. Muñoz, M. Rojas, L. A. González, G. Vásquez

Our aim was to characterize glomerular monocytes (Mo) infiltration and to correlate them with peripheral circulating Mo subsets and severity of lupus nephritis (LN). Methods. We evaluated 48 LN biopsy samples from a referral hospital. Recognition of Mo cells was done using microscopic view and immunohistochemistry stain with CD14 and CD16. Based on the number of cells, we classified LN samples as low degree of diffuse infiltration (<5 cells) and high degree of diffuse infiltration (≥5 cells). Immunophenotyping of peripheral Mo subsets was done using flow cytometry. Results. Mean age was 34.0 ± 11.7 years and the mean SLEDAI was 17.5 ± 6.9. The most common SLE manifestations were proteinuria (91%) and hypocomplementemia (75%). Severe LN was found in 70% of patients (Class III, 27%; Class IV, 43%). Severe LN patients and patients with higher grade of CD16+ infiltration had lower levels of nonclassical (CD14+CD16++) Mo in peripheral blood. Conclusions. Our results might suggest that those patients with more severe forms of LN had a higher grade of CD14+CD16+ infiltration and lower peripheral levels of nonclassical (CD14+CD16++) Mo and might reflect a recruitment process in renal tissues. However, given the small sample, our results must be interpreted carefully.

我们的目的是表征肾小球单核细胞(Mo)浸润，并将其与外周循环Mo亚群和狼疮性肾炎(LN)的严重程度联系起来。方法。我们评估了来自转诊医院的48例LN活检样本。用CD14和CD16免疫组化染色及显微镜观察对Mo细胞进行识别。根据细胞数量，我们将LN样本分为低弥漫性浸润(<5个细胞)和高弥漫性浸润(≥5个细胞)。外周血Mo亚群采用流式细胞术进行免疫分型。结果。平均年龄34.0±11.7岁，平均SLEDAI为17.5±6.9岁。最常见的SLE表现是蛋白尿(91%)和低补体血症(75%)。70%的患者存在严重LN (III类，27%;第四类，43%)。严重LN患者和CD16+浸润程度较高的患者外周血中非经典(CD14+CD16++) Mo水平较低。结论。我们的研究结果可能表明，那些更严重的LN患者具有更高级别的CD14+CD16+浸润和更低的外周非经典(CD14+CD16++) Mo水平，这可能反映了肾组织的募集过程。然而，由于样本很小，我们的结果必须仔细解释。

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引用次数: 21

Presence of DQ2.2 Associated with DQ2.5 Increases the Risk for Celiac Disease 存在DQ2.2和DQ2.5会增加患乳糜泻的风险

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-11-30 DOI: 10.1155/2016/5409653

Lucas Malta Almeida, L. Gandolfi, R. Pratesi, R. H. Uenishi, F. C. de Almeida, Nicole Selleski, Yanna Karla de Medeiros Nóbrega

Background. Celiac disease (CD) is a genetically determined immune-mediated disorder in which gluten immunogenic peptides are presented to CD4 T cells by HLA-DQ2.5, DQ8, DQ2.2, and their combinations. Our aim is to establish a risk gradient for celiac disease based on HLA-DQ profile in a brazilian representative population and the relevance of DQ2.2 in celiac disease development. Materials and Methods. 237 celiac patients and 237 controls (both groups with 164 females and 73 males) were included. All samples were tested for the presence of predisposing HLA-DQ alleles using the PCR-SSP method. Results were considered significant when p < 0.05. Disease risk was expressed as 1 : N for each HLA-DQ category described at this study. Results. DQ2.5 and/or DQ8 were detected in 224 celiac patients (94.5%) and 84 controls (35.4%). Eight celiac patients (3.4%) and 38 controls (16%) disclosed only DQ2.2. Even though DQ2.2 (β2/β2 or β2/x) showed a low CD risk of 1 : 251 and 1 : 550, respectively, the genotype DQ2.5/DQ2.2 (β2/β2) showed high CD risk of 1 : 10 (p < 0.0001). The disease risk gradient ranged from 1 : 3014 to 1 : 7. Conclusion. Our study allowed the determination of a risk gradient for celiac disease development in at-risk population, showing that DQ2.2 variant was relevant when associated with DQ2.5.

背景。乳糜泻(CD)是一种由遗传决定的免疫介导的疾病，其中谷蛋白免疫原性肽通过HLA-DQ2.5、DQ8、DQ2.2及其组合呈递给CD4 T细胞。我们的目的是基于巴西代表性人群的HLA-DQ谱和DQ2.2在乳糜泻发展中的相关性，建立乳糜泻的风险梯度。材料与方法:237例乳糜泻患者和237例对照组(两组均为女性164例，男性73例)。所有样本均采用PCR-SSP方法检测HLA-DQ易感等位基因的存在。当p < 0.05时认为结果显著。本研究中描述的每个HLA-DQ类别的疾病风险表示为1:n。结果。224例乳糜泻患者(94.5%)和84例对照组(35.4%)检测到DQ2.5和/或DQ8。8名乳糜泻患者(3.4%)和38名对照组(16%)仅披露DQ2.2。尽管DQ2.2 (β2/β2或β2/x)基因型的CD风险较低，分别为1:251和1:550，但DQ2.5/DQ2.2 (β2/β2)基因型的CD风险较高，为1:10 (p < 0.0001)。疾病风险梯度从1:30 14到1:7不等。结论。我们的研究确定了高危人群中乳糜泻发展的风险梯度，表明DQ2.2变异与DQ2.5相关。

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引用次数: 26

The Prevalence of S. aureus Skin and Soft Tissue Infections in Patients with Pemphigus 天疱疮患者金黄色葡萄球菌皮肤和软组织感染的患病率

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-10-09 DOI: 10.1155/2016/7529078

Zeinab Fagheei Aghmiyuni, A. Khorshidi, R. Moniri, T. Soori, Seyed Gholam Abbas Musavi

Pemphigus vulgaris are autoimmune blistering diseases that may result in significant morbidity and death. Immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. The aim of this study was to assess the prevalence of S. aureus infection and PVL gene in patients with pemphigus admitted to dermatology clinic. Materials and Methods. This descriptive study was conducted on 196 pemphigus vulgaris patients (119 males, 77 females) admitted to dermatology clinic between 2014 and 2015. In this study, the diagnosis of pemphigus vulgaris was made by histology, immunofluorescence pattern of perilesional skin, and indirect immunofluorescence testing of serum. Data were collected through a questionnaire. Results. 59.1% of pemphigus vulgaris patients had S. aureus infection. 49 out of 116 were methicillin-resistant. PVL gene was detected in 25 out of 116 S. aureus positive patients. Conclusion. This is the first report of S. aureus infection in pemphigus patients in Iran. More than forty percent of isolates were methicillin-resistant S. aureus. PVL gene carried by methicillin-resistant S. aureus was high in this study.

寻常型天疱疮是一种自身免疫性水疱疾病，可导致显著的发病率和死亡率。寻常型天疱疮的免疫抑制治疗使患者易受感染。本研究的目的是评估在皮肤科门诊就诊的天疱疮患者中金黄色葡萄球菌感染和PVL基因的患病率。材料与方法。对2014 - 2015年皮肤科门诊就诊的196例寻常型天疱疮患者(男119例，女77例)进行描述性研究。本研究对寻常型天疱疮的诊断采用组织学、病灶周围皮肤免疫荧光图及血清间接免疫荧光检测。通过问卷调查收集数据。结果:59.1%的寻常型天疱疮患者存在金黄色葡萄球菌感染。116例中有49例对甲氧西林耐药。116例金黄色葡萄球菌阳性患者中有25例检测到PVL基因。结论。这是伊朗天疱疮患者中首次报道金黄色葡萄球菌感染。超过40%的分离株是耐甲氧西林金黄色葡萄球菌。本研究耐甲氧西林金黄色葡萄球菌PVL基因含量较高。

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引用次数: 7

Increased Circulating Th17 Cells, Serum IL-17A, and IL-23 in Takayasu Arteritis 高须动脉炎患者循环Th17细胞、血清IL-17A和IL-23增加

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-03-13 DOI: 10.1155/2016/7841718

D. Misra, S. Chaurasia, R. Misra

Introduction. Th17, γδT, NK, and NKT cells in peripheral blood and serum IL-17 and IL-23 in Takayasu arteritis (TA) were measured and correlated with disease activity. Methods. Th17 (anti-CD3APC, CD4PECy7, and IL-17PE), NKT, NK (anti-CD3APC, CD56FITC), and γδT (anti-CD3FITC and γδTCRAPC) cells were enumerated by flow cytometry in peripheral blood of 30 patients with TA (ACR1990 criteria) and 20 healthy controls, serum IL-17 and IL-23 measured by ELISA. Relation with disease activity (NIH criteria, ITAS2010) was analyzed (using nonparametric tests, median with interquartile range). Results. Mean age of patients was 33.47 ± 11.78 years (25 females); mean symptom duration was 7.1 ± 5.3 years. 13 were not on immunosuppressants; 12 were active (ITAS2010 ≥ 4). The percentage of Th17 cells was significantly expanded in TA (patients 2.1 (1.5–3.2) versus controls 0.75 (0.32–1.2); p < 0.0001) with no differences in other cell populations. Serum IL-17 and IL-23 (pg/mL) in patients (6.2 (4.6–8.5) and 15 (14.9–26.5), resp.) were significantly higher (p < 0.001) than controls (3.9 (3.9–7.3) and undetectable median value, resp.). Subgroup analysis revealed no correlation of Th17 cells, serum IL-17, and IL-23 with disease activity or medications, nor any significant difference before and after medication. Conclusions. There is significant expansion of Th17 cells and elevated serum IL-17 and IL-23 levels in TA patients compared to healthy controls.

介绍。测定高松动脉炎(TA)患者外周血Th17、γδT、NK、NKT细胞及血清IL-17、IL-23与疾病活动性的相关性。方法。采用流式细胞术检测30例TA (ACR1990标准)患者和20例健康对照者外周血中Th17(抗cd3apc、CD4PECy7和IL-17PE)、NKT、NK(抗cd3apc、CD56FITC)和γδT(抗cd3fitc和γδTCRAPC)细胞，ELISA检测血清IL-17和IL-23。分析与疾病活动性的关系(NIH标准，ITAS2010)(使用非参数检验，中位数为四分位数范围)。结果。患者平均年龄33.47±11.78岁(女性25例);平均症状持续时间为7.1±5.3年。13例未使用免疫抑制剂;12个活跃(ITAS2010≥4)。TA中Th17细胞的百分比显著增加(患者2.1(1.5-3.2)，对照组0.75 (0.32-1.2);P < 0.0001)，其他细胞群无差异。患者血清IL-17和IL-23 (pg/mL)(分别为6.2(4.6-8.5)和15 (14.9-26.5)，p < 0.001)显著高于对照组(3.9(3.9 - 7.3)，中位值无法检测，p < 0.001)。亚组分析显示Th17细胞、血清IL-17和IL-23与疾病活动度或药物治疗无相关性，用药前后无显著差异。结论。与健康对照相比，TA患者Th17细胞显著扩增，血清IL-17和IL-23水平升高。

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引用次数: 50

Mechanism of Xinfeng Capsule on Adjuvant-Induced Arthritis via Analysis of Urinary Metabolomic Profiles 心风胶囊治疗佐剂性关节炎的作用机制:尿代谢组学分析

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-02-18 DOI: 10.1155/2016/5690935

Hui Jiang, Jian Liu, Ting Wang, Jiarong Gao, Yue Sun, Chuanbing Huang, Mei Meng, Xiu-juan Qin

We aimed to explore the potential effects of Xinfeng capsule (XFC) on urine metabolic profiling in adjuvant-induced arthritis (AA) rats by using gas chromatography time-of-flight mass spectrometry (GC-TOF/MS). GC-TOF/MS technology was combined with multivariate statistical approaches, such as principal component analysis (PCA), partial least squares discriminant analysis (PLS-DA), and orthogonal projections to latent structures discriminant analysis (OPLS-DA). These methods were used to distinguish the healthy group, untreated group, and XFC treated group and elucidate potential biomarkers. Nine potential biomarkers such as hippuric acid, adenine, and L-dopa were identified as potential biomarkers, indicating that purine metabolism, fat metabolism, amino acid metabolism, and energy metabolism were disturbed in AA rats. This study demonstrated that XFC is efficacious for RA and explained its potential metabolomics mechanism.

本研究旨在利用气相色谱-飞行时间质谱(GC-TOF/MS)技术探讨心风胶囊(XFC)对佐剂性关节炎(AA)大鼠尿液代谢谱的潜在影响。GC-TOF/MS技术结合多元统计方法，如主成分分析(PCA)、偏最小二乘判别分析(PLS-DA)和正交投影到潜在结构判别分析(OPLS-DA)。这些方法用于区分健康组、未治疗组和XFC治疗组，并阐明潜在的生物标志物。发现海马酸、腺嘌呤、左旋多巴等9种潜在生物标志物，表明AA大鼠嘌呤代谢、脂肪代谢、氨基酸代谢和能量代谢受到干扰。本研究表明XFC对RA有效，并解释了其潜在的代谢组学机制。

引用次数: 6

Prooxidant-Antioxidant Balance in Patients with Systemic Lupus Erythematosus and Its Relationship with Clinical and Laboratory Findings 系统性红斑狼疮患者的促氧化-抗氧化平衡及其与临床和实验室结果的关系

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-01-26 DOI: 10.1155/2016/4343514

S. Jafari, S. Salimi, A. Nakhaee, H. Kalani, S. Tavallaie, F. Farajian-Mashhadi, Z. Zakeri, M. Sandoughi

Aim. This study was aimed at evaluating prooxidant-antioxidant balance (PAB) in patients with systemic lupus erythematosus (SLE) and its relationship with laboratory findings and clinical manifestations. Methods. In this case-control study, 60 patients with SLE and 60 healthy individuals were enrolled. The blood samples were collected and their sera were separated. Subsequently, the prooxidant-antioxidant balance value was evaluated using PAB assay for each sample. Results. The mean of PAB values in SLE patients was significantly higher than healthy controls (147.3 ± 42 versus 84.8 ± 32.2 HK, P < 0.0001). Furthermore, in SLE patients, there was a positive significant correlation between the PAB and erythrocyte sedimentation rate (ESR) (r = 0.492, P < 0.001). In addition, the PAB values in patients with alopecia, discoid rash, oral ulcers, arthritis, and nephritis were significantly higher than those without these manifestations. Conclusion. The findings of current study showed that the mean of PAB was significantly higher in SLE patients and PAB was correlated with ESR. Moreover increased PAB was found in SLE patients with alopecia, discoid rash, oral ulcers, arthritis, and nephritis. These findings suggest that the measurement of PAB may be useful to show oxidative stress condition in SLE patients.

的目标。本研究旨在评估系统性红斑狼疮(SLE)患者的促氧化-抗氧化平衡(PAB)及其与实验室结果和临床表现的关系。方法。在这项病例对照研究中，60名SLE患者和60名健康个体被纳入研究。采集血样，分离血清。随后，使用PAB法评估每个样品的促氧化剂-抗氧化剂平衡值。结果。SLE患者PAB均值显著高于健康对照组(147.3±42 vs 84.8±32.2 HK, P < 0.0001)。此外，在SLE患者中，PAB与红细胞沉降率(ESR)呈正相关(r = 0.492, P < 0.001)。此外，有脱发、盘状皮疹、口腔溃疡、关节炎和肾炎的患者PAB值明显高于无这些表现的患者。结论。本研究结果显示，SLE患者PAB的平均值明显较高，且PAB与ESR相关。此外，在伴有脱发、盘状皮疹、口腔溃疡、关节炎和肾炎的SLE患者中发现PAB增加。这些发现表明，PAB的测量可能有助于显示SLE患者的氧化应激状况。

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引用次数: 4

Risk Factors and Adverse Events Poorly Predict Infections and Hypogammaglobulinemia in Granulomatosis with Polyangiitis Patients Receiving Rituximab 危险因素和不良事件难以预测接受利妥昔单抗的肉芽肿合并多血管炎患者的感染和低丙种球蛋白血症

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-01-18 DOI: 10.1155/2016/8095695

E. Besada

Background. 29 GPA patients from the Northern Norway vasculitis disease registry received rituximab (RTX) induction and maintenance. 24% and 31% had, respectively, severe and chronic infections while 45% had hypogammaglobulinemia and 28% discontinued RTX due to hypogammaglobulinemia. The aim of the study was to examine how known predictors and adverse events interacted with adverse events using structural statistical methods. Methods. Five predictors (age, cyclophosphamide, total Ig and CD4/CD8 ratio prior RTX, and type of RTX maintenance regimen) and 4 adverse events (severe and chronic infections, hypogammaglobulinemia, and RTX discontinuation) were modeled in principal component and redundancy analyses. Results. The 5 predictors explained 51% of the variance of the GPA cohort. Models including cyclophosphamide exposure and total Ig level predicted best adverse events. However total Ig level has low R squared. The 2 best combinations of adverse events explained 13% of the variance of the predictors and adverse events. Only chronic infections were associated with combination of all adverse events (P = 0.014). Hypogammaglobulinemia did not seem associated with the other adverse events. Conclusions. Traditional risk factors for infections and hypogammaglobulinemia seemed to poorly predict adverse events in our GPA cohort.

背景:来自北挪威血管炎疾病登记处的29例GPA患者接受了利妥昔单抗(RTX)诱导和维持。分别有24%和31%的患者患有严重和慢性感染，45%的患者患有低γ球蛋白血症，28%的患者因低γ球蛋白血症而停用RTX。该研究的目的是使用结构统计方法检查已知的预测因素和不良事件如何与不良事件相互作用。方法。5个预测因子(年龄、环磷酰胺、总Ig和CD4/CD8比值，以及RTX维持方案类型)和4个不良事件(严重和慢性感染、低γ球蛋白血症和RTX停药)在主成分和余度分析中建模。结果。这5个预测因子解释了GPA队列中51%的方差。包括环磷酰胺暴露和总Ig水平在内的模型预测最佳不良事件。然而，总Ig水平的R平方较低。不良事件的2个最佳组合解释了13%的预测因子和不良事件方差。只有慢性感染与所有不良事件的合并相关(P = 0.014)。低γ -球蛋白血症似乎与其他不良事件无关。结论。在我们的GPA队列中，感染和低丙种球蛋白血症的传统危险因素似乎很难预测不良事件。

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引用次数: 8

Correlation of Serum Soluble Interleukin-7 Receptor and Anti-C1q Antibody in Patients with Systemic Lupus Erythematosus. 系统性红斑狼疮患者血清可溶性白介素-7受体与抗c1q抗体的相关性

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-01-01 Epub Date: 2016-03-16 DOI: 10.1155/2016/8252605

Shuhong Chi, Jing Xue, Feng Li, Caixia Zhu, Yunxia Yu, Haibo Li, Xuemei Wang, Yurong Zhang, Jijuan Yang, Shaolan Zhou, Lijuan Yang, Chen Ji, Xiaoming Liu

Background. Serum concentrations of soluble interleukin-7 receptor (sIL-7R) and anti-C1q antibody have recently been identified as unique serological markers for lupus nephritis (LN) in patients with systemic lupus erythematosus (SLE). In this study, we evaluated the correlation of serum sIL-7R and anti-C1q in SLE patients. Methods. Sera from 134 patients with SLE and 84 healthy cohorts were tested for levels of sIL-7R and anti-C1q antibodies in terms of ELISA. Correlations of the sIL-7R and anti-C1q autoantibodies were evaluated. Results. The serum concentrations of sIL-7R and anti-C1q antibodies were significantly higher in SLE patients and LN patients in comparison with healthy individuals/controls and SLE patients with non-LN, respectively. In addition, both sIL-7R and anti-C1q concentrations were found to significantly correlate with the SLE disease activity as evaluated by SLEDAI scores. Interestingly, the serum sIL-7R concentration was strongly correlated with the level of anti-C1q antibodies (r = 0.2871, p = 0.0008) but not statistically correlated with other serological markers, including the anti-dsDNA and complements C3 and C4 concentrations in SLE patients. Conclusion. Both serum sIL-7R and anti-C1q antibodies were strongly associated with disease activity and LN in SLE patients, suggesting that they may be reliable serological markers for identification of SLE patients with active diseases and LN.

背景。可溶性白细胞介素-7受体(sIL-7R)和抗c1q抗体的血清浓度最近被确定为系统性红斑狼疮(SLE)患者狼疮肾炎(LN)的独特血清学标志物。在本研究中，我们评估SLE患者血清sIL-7R与抗c1q的相关性。方法。通过ELISA检测134例SLE患者和84例健康人群的血清sIL-7R和抗c1q抗体水平。评估sIL-7R和抗c1q自身抗体的相关性。结果。SLE患者和LN患者血清sIL-7R和抗c1q抗体浓度分别显著高于健康个体/对照组和非LN SLE患者。此外，sIL-7R和抗c1q浓度被发现与SLE疾病活动性显著相关，通过SLEDAI评分评估。有趣的是，SLE患者血清sIL-7R浓度与抗c1q抗体水平呈强相关(r = 0.2871, p = 0.0008)，但与其他血清学指标(包括抗dsdna和补体C3、C4浓度)无统计学相关性。结论。血清sIL-7R和抗c1q抗体均与SLE患者的疾病活动性和LN密切相关，提示它们可能是鉴别SLE患者活动性疾病和LN的可靠血清学标志物。

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引用次数: 13

[(18)F]-Fluoro-Deoxy-Glucose Positron Emission Tomography Scan Should Be Obtained Early in Cases of Autoimmune Encephalitis. [(18)F]-自身免疫性脑炎应及早进行氟脱氧葡萄糖正电子发射断层扫描。

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2016-01-01 Epub Date: 2016-07-31 DOI: 10.1155/2016/9450452

C R Newey, A Sarwal, S Hantus

Introduction. Autoimmune encephalitis (AE) is a clinically challenging diagnosis with nonspecific neurological symptoms. Prompt diagnosis is important and often relies on neuroimaging. We present a case series of AE highlighting the importance of an early [(18)F]-fluoro-deoxy-glucose positron emission tomography (FDG-PET) scan. Methods. Retrospective review of seven consecutive cases of autoimmune encephalitis. Results. All patients had both magnetic resonance imaging (MRI) and FDG-PET scans. Initial clinical presentations included altered mental status and/or new onset seizures. Six cases had serum voltage-gated potassium channel (VGKC) antibody and one had serum N-methyl-D-aspartate (NMDA) antibody. MRI of brain showed mesial temporal lobe hyperintensity in five cases of VGKC. The other two patients with VGKC or NMDA AE had restiform body hyperintensity on MRI brain or a normal MRI, respectively. Mesial temporal lobe hypermetabolism was noted in three cases on FDG-PET, despite initial unremarkable MRI. Malignancy workup was negative in all patients. Conclusion. A high index of suspicion for AE should be maintained in patients presenting with cognitive symptoms, seizures, and limbic changes on neuroimaging. In cases with normal initial brain MRI, FDG-PET can be positive. Additionally, extralimbic hyperintensity on MRI may also be observed.

介绍。自身免疫性脑炎(AE)是一种具有非特异性神经症状的临床挑战性诊断。及时诊断很重要，通常依赖于神经影像学。我们提出一系列AE病例，强调早期[(18)F]-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)扫描的重要性。方法。连续7例自身免疫性脑炎的回顾性分析。结果。所有患者均行磁共振成像(MRI)和FDG-PET扫描。最初的临床表现包括精神状态改变和/或新发癫痫发作。血清电压门控钾通道(VGKC)抗体6例，血清n -甲基- d -天冬氨酸(NMDA)抗体1例。5例VGKC脑MRI表现为颞叶内侧高信号。另外2例VGKC或NMDA AE患者MRI脑或MRI正常分别表现为恢复性体高信号。在FDG-PET上发现了3例颞叶内侧高代谢，尽管最初的MRI表现不明显。所有患者的恶性检查均为阴性。结论。在出现认知症状、癫痫发作和神经影像学改变的患者中，应保持对AE的高度怀疑。在初始脑MRI正常的病例中，FDG-PET可呈阳性。此外，MRI上也可观察到边缘外高信号。

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引用次数: 21

Pentraxin 3 Plasma Levels and Disease Activity in Systemic Lupus Erythematosus 系统性红斑狼疮患者戊烷素3血浆水平与疾病活动性

IF 4 Q4 IMMUNOLOGY

Autoimmune Diseases

Pub Date : 2015-11-03 DOI: 10.1155/2015/354014

R. Assandri, M. Monari, A. Colombo, Alessandra Dossi, A. Montanelli

SLE is an autoimmune disorder that involves polyclonal autoimmunity against multiple autoantigens. PTX3, a marker of the acute-phase inflammatory response, plays an important role in innate immunity and in modulation of the adaptive immune response. Our study tried to resolve some rather controversial aspects of the use of PTX3 as a biomarker of disease activity in SLE patients. We demonstrated that plasma PTX3 concentration of the SLE patients was significantly higher than the healthy control groups and reflected disease activity. ROC curve analysis was used to determine best cut-off point (2.8 ng/mL) with a good sensitivity and specificity. In patients with SLE, PTX3 concentrations were correlated with SLEDAI. Trend to remission (TTR) curve was created by plotting PTX3 levels and SLEDAI and we applied the curve as a model for the analysis of two patients with different follow-up. PTX3 plasma levels declined significantly and this decline occurred parallel to the clinical improvement with a complete remission of disease. In patients who experienced a clinical relapse, an increase in PTX3 levels followed the lupus flare. The proposal of PTX3 cut-off associated with TTR and monitoring of PTX3 plasma levels could be an innovative approach to follow-up of SLE patients.

SLE是一种自身免疫性疾病，涉及针对多种自身抗原的多克隆自身免疫。PTX3是急性期炎症反应的标志物，在先天免疫和适应性免疫反应的调节中发挥重要作用。我们的研究试图解决使用PTX3作为SLE患者疾病活动性生物标志物的一些相当有争议的方面。我们证明SLE患者的血浆PTX3浓度显著高于健康对照组，反映了疾病的活动性。采用ROC曲线分析确定最佳分界点(2.8 ng/mL)，具有良好的敏感性和特异性。在SLE患者中，PTX3浓度与SLEDAI相关。通过绘制PTX3水平和SLEDAI形成缓解趋势(TTR)曲线，并将该曲线作为模型对两例不同随访的患者进行分析。PTX3血浆水平显著下降，这种下降与疾病完全缓解的临床改善同时发生。在经历临床复发的患者中，PTX3水平随狼疮发作而升高。提出与TTR相关的PTX3截止值和监测PTX3血浆水平可能是SLE患者随访的一种创新方法。

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引用次数: 22